Predictive factors for massive hemorrhage in women with retained products of conception: a prospective study

被引：6

作者：

Sonehara, Reina ^{[1
]}

Nakamura, Tomoko ^{[1
]}

Iwase, Akira ^{[2
]}

Nishida, Kazuki ^{[3
]}

Takikawa, Sachiko ^{[4
]}

Murakami, Mayuko ^{[1
]}

Yoshita, Sayako ^{[1
]}

Muraoka, Ayako ^{[1
]}

Miyake, Natsuki ^{[5
]}

Nakanishi, Natsuki ^{[1
]}

Osuka, Satoko ^{[5
]}

Goto, Maki ^{[1
]}

Kajiyama, Hiroaki ^{[1
]}

机构：

[1] Nagoya Univ, Dept Obstet & Gynecol, Grad Sch Med, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

[2] Gunma Univ, Dept Obstet & Gynecol, Grad Sch Med, 3-39-22 Showa Machi, Maebashi, Gumma 3718511, Japan

[3] Nagoya Univ Hosp, Ctr Adv Med & Clin Res, Dept Biostat Sect, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

[4] Clin Mama, 3-34-1 Imajuku, Ogaki, Gifu 5030807, Japan

[5] Nagoya Univ Hosp, Dept Maternal & Perinatal Med, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

来源：

SCIENTIFIC REPORTS | 2022年 / 12卷 / 01期

关键词：

PLACENTA-ACCRETA; MANAGEMENT; COMPLICATIONS; EMBOLIZATION; FEATURES;

D O I：

10.1038/s41598-022-15564-1

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Retained products of conception (RPOC) is a common cause of postpartum bleeding, which may be life-threatening; however, no evidence-based guidelines exist to assist in evaluating the risk of massive hemorrhage in women with RPOC. In this prospective study, we aimed to evaluate the predictive factors for massive hemorrhage in women with RPOC. The primary and secondary endpoints were to validate the usefulness of power Doppler color scoring (PDCS) in evaluating hypervascularity and to identify other predictive factors (such as maximum RPOC diameter and serum beta hCG and Hb level at first visit), respectively. Among the 51 women with RPOC included in this study, 16 (31.5%) experienced massive hemorrhage during follow-up. None of the women with PDCS 1 or 2 (18) experienced massive hemorrhage, whereas 16 (48.5%) women with PDCS 3 or 4 (33) did. Multiple logistic regression analysis showed that the odds ratio [95% confidence interval] (P value) for PDCS, assisted reproductive technology (ART), and low serum hemoglobin (Hb) levels were 22.39 [2.25 - 3087.92] (P = 0.004), 5.72 [1.28 - 33.29] (P = 0.022), and 4.24 [0.97 - 22.99] (P = 0.056), respectively. Further, the decision tree method identified PDCS, ART, and low serum Hb levels as potential predictive factors for massive hemorrhage. This study identified PDCS as useful predictor of massive hemorrhage in women with RPOC. With additional inclusion of factors such as ART and low serum Hb levels, the risk of massive hemorrhage may be effectively evaluated, leading to better management of women of reproductive age.

引用

页数：7

共 28 条

[1] Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment [J].